title: Hurricane Katrina: impact on cardiac surgery case volume and outcomes.
abstract: Hurricane Katrina produced a surge of patient referrals to our facility for cardiac surgery. We sought to determine the impact of this abrupt volume change on operative outcomes. Using our cardiac surgery database, which is part of the Department of Veterans Affairs' Continuous Improvement in Cardiac Surgery Program, we compared procedural outcomes for all cardiac operations that were performed in the year before the hurricane (Year A, 29 August 2004-28 August 2005) and the year after (Year B, 30 August 2005-29 August 2006). Mortality was examined as unadjusted rates and as risk-adjusted observed-to-expected ratios. We identified 433 cardiac surgery cases: 143 (33%) from Year A and 290 (67%) from Year B. The operative mortality rate was 2.8% during Year A (observed-to-expected ratio, 0.4) and 2.8% during Year B (observed-to-expected ratio, 0.6) (P = 0.9). We identified several factors that enabled our institution to accommodate the increase in surgical volume during the study period. We conclude that, although Hurricane Katrina caused a sudden, dramatic increase in the number of cardiac operations that were performed at our facility, good surgical outcomes were maintained.
authors.affiliation: Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA. fbakaeen@bcm.edu
authors.forename: Faisal G
authors.initials: FG
authors.lastname: Bakaeen
authors.forename: Joseph
authors.initials: J
authors.lastname: Huh
authors.forename: Danny
authors.initials: D
authors.lastname: Chu
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Coselli
authors.forename: Scott A
authors.initials: SA
authors.lastname: LeMaire
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Mattox
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Wall
authors.forename: Xing Li
authors.initials: XL
authors.lastname: Wang
authors.forename: Salwa A
authors.initials: SA
authors.lastname: Shenaq
authors.forename: Prasad V
authors.initials: PV
authors.lastname: Atluri
authors.forename: Samir S
authors.initials: SS
authors.lastname: Awad
authors.forename: David H
authors.initials: DH
authors.lastname: Berger
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality / Q000601:surgery*; D055867:Cyclonic Storms; D004526:Efficiency; D005260:Female; D005500:Follow-Up Studies; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012086:Reoperation / Q000401:mortality; D012307:Risk Factors; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D013781:Texas; D014600:Utilization Review / Q000706:statistics & numerical data; D016526:Workload / Q000706:statistics & numerical data